Factors associated with remaining on initial randomized efavirenz-containing regimens

aCenter for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts bFred Hutchinson Cancer Research Center, Seattle, Washington cUniversity of Washington, Seattle, Washington dNorthwestern University Feinberg School of Medicine, Division of Infectious Diseases, Chicago, Illinois eBirmingham Veterans Affairs Medical Center and University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
AIDS (London, England) (Impact Factor: 5.55). 07/2013; 27(12):1887-97. DOI: 10.1097/QAD.0b013e328361645f
Source: PubMed


Efavirenz (EFV) along with two nucleoside reverse transcriptase inhibitors (NRTIs) is a recommended initial antiretroviral regimen. Understanding characteristics related to EFV success is clinically useful.
Data from 2220 antiretroviral-naive participants randomized to EFV and two to three NRTIs in four ACTG trials as well as a long-term cohort were analysed.
Logistic regression, using inverse probability of censoring weighting to address selective-follow-up bias, was used to identify factors associated with EFV success (no treatment interruptions of >30 days, HIV RNA < 200 copies/ml) 1 year post initiation and at years 2-5 if successful at year 1.
Pretreatment characteristics were median age 38 years, 82% male, 40% white, 10% history of IDU (HxIDU), median CD4 T-lymphocyte 227 cells/μl and 33% HIV RNA more than 100 000 copies/ml. In a multivariable model, factors associated with year 1 EFV success were race [white odds ratio (OR) 1.5; P < 0.001; Hispanic OR 1.5; P = 0.003 vs. black], no pretreatment sign/symptom grade 3 or higher (OR 1.7; P = 0.008) and no HxIDU (OR 1.7; P = 0.001). Predictors of EFV success at years 2-5 were no HxIDU (years 2-5; ORs 1.9-2.2); self-reported complete (4 days prior to study visit) adherence during year 1 (years 2-4; ORs 1.6-1.9); fewer missed visits during year 1 (years 2, 4, 5; ORs 0.92-0.98/1% increase); HIV RNA less than 50 copies/ml at year 1 (years 2, 3; ORs 1.9-2.2); and older age (>50 vs. ≤30 years) (years 2-4: ORs 2.3-3.7).
Characteristics predictive of EFV success in the short-term and longer term differed except for HxIDU. Behaviours occurring during year 1 were associated with EFV success over 5 years.

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    ABSTRACT: In the analysis of longitudinal or panel data, neglecting the serial correlations among the repeated measurements within subjects may lead to inefficient inference. In particular, when the number of repeated measurements is large, it may be desirable to model the serial correlations more generally. An appealing approach is to accommodate the serial correlations nonparametrically. In this article, we propose a moving blocks empirical likelihood method for general estimating equations. Asymptotic results are derived under sequential limits. Simulation studies are conducted to investigate the finite sample performances of the proposed methods and compare them with the elementwise and subject-wise empirical likelihood methods of Wang et al. (2010, Biometrika 97, 79-93) and the block empirical likelihood method of You et al. (2006, Can. J. Statist. 34, 79-96). An application to an AIDS longitudinal study is presented. © 2015, The International Biometric Society.
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